This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Saturday, October 31, 2015

Weekly Overseas Health IT Links -31st October, 2015.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

People over the age of 60 are likely to be driving the healthcare market around the world in less than five years, according to global research firm Frost & Sullivan.

By 2020, Frost & Sullivan estimates 22 percent of the world's population will be age 60 or older. In order to encourage independent living, IT service providers need to support the development of smart homes and communities that leverage technology-based solutions for the aged, researchers conclude.

The report identifies three anticipated market trends that could help aging people participate in their healthcare:

High adoption of remote monitoring devices, which are useful for personal physicians, nurses and family, will help all senior citizens who prefer to stay in their own homes.

Information and communication technology-based assistive technologies, including computer-based or other electronic communication aids, object locators and reminder systems, will also gain traction.

Employing robots as a support system will emerge as an excellent aged care model.

When it comes to the widespread use of the Fast Healthcare Interoperability Resources (FHIR) standard, Geisinger Health System Chief Clinical Informatics Officer Alistair Erskine calls himself impatient but optimistic. Erskine has helped Geisinger to develop a number of applications that take advantage of FHIR and public application programming interfaces to be able to exchange information with multiple electronic health record systems, but he'd like to see more.

"I think we need some real world examples, both of an implementation within a particular organization, but also of an app store for healthcare that would be vendor neutral and agnostic," Erskine told FierceHealthIT at last week's College of Healthcare Information Management Executives fall forum in Orlando. "The latter would have a mechanism to curate these apps, make sure they do what they say they'll do and be able to distribute that to the people who want to be able to consume them."

For patients with acute myocardial infarction, electronic health record implementation is associated with some improvement in outcomes, according to a study published online Oct. 20 in Circulation: Cardiovascular Quality and Outcomes.

THURSDAY, Oct. 22, 2015 (HealthDay News) -- For patients with acute myocardial infarction (MI), electronic health record (EHR) implementation is associated with some improvement in outcomes, according to a study published online Oct. 20 in Circulation: Cardiovascular Quality and Outcomes.

Jonathan R. Enriquez, M.D., from the University of Missouri in Kansas City, and colleagues examined the correlation of EHR use with quality of care and outcomes after MI. They compared outcomes for patients treated at hospitals with a fully-implemented EHR (43,527 patients), partially-implemented EHR (72,029 patients), and no EHR (9,270 patients).

It’s never been more dangerous to visit a healthcare-related website. From insurance companies to self-help websites, hackers launched more attacks on the health industry than any other over the first half of 2015.

That’s according to a report published Thursday by G Data, the German cybersecurity company that regularly tracks cybercrime. This report, the first of two scheduled on malicious software activity in 2015, determined that 26.6 percent of all malware attacks were aimed at health sites. Compare that to 10.2 percent in the second half of 2014 and 6.5 percent in the first half of 2014.

“It could be insurance fraud,” said Andy Hayter, security evangelist at G Data, when asked about the possible motivation for the attacks. “This means people are hacking websites so that when you go there, you’re actually being redirected to a key logger or something that’s collecting information on you. … Healthcare websites are becoming more evil in the past year than they ever have before.”

Nestled in the gently rolling hills of Verona, Wisconsin, a small Madison suburb, is the 1,000-acre "Intergalactic Headquarters" of Epic Systems, the multibillion-dollar company that claims its software manages medical records for 179 million Americans—or 56 percent of the country. Epic's HQ features a conference room tucked in a tree house. There's a Dungeons & Dragons-themed building with a moat and a replica drawbridge. One corridor is modeled to resemble a New York City subway car, complete with a statue of a homeless guy asleep on a bench. A group of Harry Potter-inspired office buildings dubbed the "Wizards Academy" is currently under construction.

Judith Faulkner, Epic's 72-year-old founder and one of just 18 women on Forbes' list of self-made billionaires[1], often dresses in costume (Lucille Ball, a Hogwarts wizard) at the company's annual meeting, which draws thousands of hospital executives and IT officers to the company's 11,400-seat Deep Space Auditorium[2]. Her motto: "Do good. Have fun. Make money."

Electronic health record vendor contracts must be changed to allow for more examination of patient safety without researchers having to worry about obtaining vendor permission or gag clauses affecting their work, according to a new post by Kathy Kenyon, a former project officer with the Office of the National Coordinator for Health IT, in the Health Affairs Blog.

Kenyon states that much of the attention on gag clauses barring physicians from complaining about their systems is misplaced; the real problem, she says, is gag clauses that stifle research. Those gag values, which are related to confidentiality and intellectual property terms, are unclear and overbroad.

Providing pharmacists with access to a physician's electronic health record can improve efficiencies and communication between them, according to a new study in the American Health Information Management Association's Perspectives inHealth Information Management.

Much physician-pharmacy interaction for information, such as medication adherence and prescription verification, is handled by fax or telephone, which are both inefficient and distracting. In an effort to improve the flow of information, a supermarket chain pharmacy approached a nearby physician's office to discuss medication therapy management to reinforce the physician's care plans and reduce questions about prescriptions from the pharmacy.

Hospitals are taking a page from retail and other industries by expanding use of technology to cut costs in their supply chains, according to an article in The Wall Street Journal.

In retail, for instance, once a customer scans an item at checkout, the supply chain system automatically tracks that change in inventory. In contrast, hospitals have often relied on counting or guessing estimates for their inventory levels with a range of employees handling products, according to the article.

At BJC HealthCare, which operates a network of 12 hospitals in Illinois and Missouri, expanded use of radio frequency identification (RFID) tags helps hospitals track medical devices and new orders, and lend supplies to other facilities. Those tags send information to a main database that can track if items expire. The system has helped the organization reduce the required stock kept on hand by 23 percent in tests, according to the health system.

New European regulations mean that all prescription medicines will need to carry a barcode on their packaging to reduce the risk of counterfeit and unsafe drugs entering the healthcare system.

Earlier this month, the European Commission formally adopted the delegated act on safety features for medicinal products for human use, which implements some of the requirements of the Falsified Medicines Directive – legislation that came into force in January 2013 to ensure the safety of medicines.

One of the measures of the Falsified Medicines Directive when it was passed was an “obligatory authenticity feature on the outer packaging of the medicines” that would be decided at a later stage via a delegated act.

An online pharmacy part-owned by Emis Health faces a £130,000 fine after it sold customer details to a direct marketing company.

An Information Commissioner's Office report says that information from 21,500 patients who used the Pharmacy2U service had been offered for sale through Alchemy Direct Media during November and December 2014.

These details were purchased by several companies, including Healthy Marketing, a mail-order health supplements company that the ICO said has been cautioned for an advertisement that contained unauthorised health claims.

England’s two major GP clinical system suppliers are about to begin trialling a direct integration between their systems to allow GPs to share patient records more easily.

TPP and Emis are working with Central London Community Healthcare NHS Trust and NHS Waltham Forest Clinical Commissioning Group on two pilots that will allow users of Emis Web or TPP’s SystmOne to view data stored on the other system without the need for an external integration service.

The pilot at Central London Community Healthcare will allow the trust’s rapid response team, which uses the SystmOne Community module, to view data in real-time from GP practices using Emis Web. The pilot at Waltham Forest will see records shared between a SystmOne GP practice and an extended hours service using Emis Web.

Twelve EHR vendors have agreed to adopt a set of metrics and conduct ongoing reporting in an effort to further interoperability.

The consensus occurred at the KLAS Keystone Summit in Utah. The vendors "proactively stepped forward to have an independent entity publish transparent measures of health information exchange that can serve as the basis for understanding our current position and trajectory," according to a statement issued by the research firm. "Assisted by leading provider organizations and informatics experts, these executive officers knocked down barriers to arrive at measures to improve interoperability for the public good. Vendors and providers willingly committed to go arm in arm to work closely with Washington to help alleviate the interoperability-measurement burden faced by the government."

Technological tools used to diagnose and treat mental health issues may help to offset barriers that continue to prevent millions of Americans from getting the care they need.

Nearly 60% of adults with a mental illness fail to get treatment each year, according to the National Alliance on Mental Illness. The use of telemedicine is proving to be an effective way to reach underserved groups, as well as to improve care coordination and connect people to peer support. Although use of this technology is not yet widespread, the market is growing.

According to the American Psychological Association's Center for Workforce Studies, practitioners' use of videoconferencing with clients increased from 2% in 2000 to 10% in 2008. Further, consumers increasingly are tapping into a range of mobile applications designed to screen for anxiety and depression, manage stress, gain on-the-go access to self-help resources and help peoplewith suicidal thoughts seek help. Other tools help people track their mood and share the information they capture with their health care providers. And apps, like the Department of Veterans Affairs' PTSD Coach, help people manage symptoms that are common after experiencing a trauma.

Healthcare analytics approaches are growing in maturity, helping providers achieve savings and efficiencies in a variety of areas, ranging from cutting supply acquisition costs to helping them analyze which patients need specific types of care.

At the Tableau Conference in Las Vegas on Tuesday, several providers offered insights on their initiatives and spelled out some of the early successes of their efforts.

Savings on supply procurement is a key strategy at BJC Healthcare, a St. Louis-based healthcare system. Lynn Kersting, its strategic manager of supply chain analytics, said the organization is aiming to centralize purchasing and use analytics to reduce supply spending to 19 percent of total revenue, from current levels of about 23 percent.

As Fareed Zakaria sees it, the remedy for America's ailing and expensive health system is clear.

It might be hard for some to swallow, but, in his view, it is sure and proven.

"There's absolutely no question that when we look at the ability to provide good healthcare at an affordable price, lower levels of massive inequality in healthcare outcomes or provision, a single government payer and multiple private providers is the answer. It's absolutely clear that is the only way you can achieve that goal," Zakaria said. "The revolution that's needed here is not an information revolution, it's a political revolution."

Zakaria is a journalist, author and host of Fareed Zakaria GPS, a Sunday morning staple on CNN that delves into global issues and ways to solve them. For purposes of his broadcast "GPS" stands for Global Public Square.

In England, vendor neutral archives tend to be associated with digital imaging. But with appropriate standards in place, they can be used for many other kinds of record. And that’s leading to a lively debate about their future; both within trusts and within wider health economies. Kim Thomas reports.

When trusts began procuring new picture archiving and communications systems two years ago, as their National Programme for IT contracts came to an end, many also decided to purchase vendor neutral archives.

VNAs offered a good way of keeping a permanent archive of radiology images, enabling trusts to have a relatively painless transition when the time came to switch contracts or even vendors.

Poor vendor coordination, trouble finding records and limited parsing abilities are among the biggest barriers to interoperability of health information, according to a new study from KLAS.

When it comes to interoperability, providers want "invisible, effortless connections that provide high patient care value," a report summary states.

The Orem, Utah-based research firm interviewed more than 200 healthcare providers over three months for its inaugural study, according to an announcement. KLAS scored electronic medical record vendors on a 1 to 5 scale based on the report's findings.

Most backers of health information exchanges believe they are improving care and generating a positive return on investment, but few of the exchanges actually offer up data to confirm those beliefs, according to a study published at Perspectives in Health Information Management.

The study is based on data from 35 community HIEs initiated in November 2013, as well as questions posed to people familiar with the exchanges. While two-thirds reported a positive ROI, one-fourth or fewer respondents reported using metrics to calculate ROI. In addition, 76 percent did not deliver reports on quality measures and 73 percent were not using data to measure quality performance of participating providers.

"Our study shows that calculating ROI for HIEs, or their impact on quality of care, remains a secondary priority for most HIEs," the authors state. "These findings, taken in combination with the ending of HITECH funding, raise serious questions about the future sustainability of HIEs, and what form they will take."

The use of virtual health solutions in primary care could save $10 billion annually when applied to annual patient visits, ongoing patient management and self-care, according to a recently released report from Accenture.

The report highlights that the U.S. is faced with health professional shortages, with a projected shortage of as many as 31,000 primary care physicians (PCPs) by 2025, according to the American Association of Medical Colleges. And, the U.S. spent $2.6 trillion on healthcare in 2010, with wages accounting for more than half of that cost.

The Accenture report states that combining virtual health and traditional patient care models can help address the nation’s clinician labor cost and capacity challenges.

Consumers want to know in advance what their outpatient services will cost. A recent survey by the Advisory Board Company's Market Innovation Center shows that 92% of patients would avoid a clinic where prices were not available in favor of one where prices were known. Giving patients outpatient pricing information is not technically difficult. Most physician offices can look up a patient in their system or the insurance company's system and find the relevant co-payment for a doctor visit or lab test. It's more a question of willingness to provide this information and operational discipline to make it convenient for the consumer.

The latest Building Security in Maturity Model (BSIMM) study illustrates the long learning curve for secure coding initiatives.

Healthcare's cybersecurity ills are well-known, and a new study of enterprise secure software development shows just how far that sector lags behind other industries.

The new Building Security in Maturity Model (BSIMM) study published today, BSIMM6, found healthcare organizations scored much lower than their counterparts in the financial services, independent software vendor, and consumer electronics industries, when it comes to internal software security programs and practices. BSIMM6 studied more than 100 enterprises including 10 firms in healthcare. Six of those healthcare firms--Aetna, ANDA, McKesson, The Advisory Board Company, Siemens and Zephyr Health--agreed to be named as part of the study, which is headed up by software security firm Cigital Inc. with the help of NetSuite.

When my doctor walks into the exam room, I want her to pay attention to me, not the computer. Not only is that what all patients want, but it's what doctors want, too. Yet doctors today are under pressure to feed the digital beasts.

Health care's latest best-selling M.D. author, Bob Watcher, says that in a 10-hour shift a single doctor might record 4,000 clicks. Worse, much of this activity is routine census taking, driven by insurers and regulators who assume digitization makes it easy to gather statistical data, regardless of whether it contributes to the quality of care.

Doctors are not Luddites. Many were initially enthusiastic at the thought of automating their practices, expecting the same kind of usability and productivity they enjoyed with, say, the software they use to do their taxes. The expectation was that software for medical professionals would at least be that good. The reality is that the more "digital" physicians go, and the longer they use software, the less satisfied they become.

Meaningful use deadlines took center stage at the annual meeting of the College of Healthcare Information Management Executives (CHIME) in Orlando, FL, last week. But attendees also found time to talk about what comes after meaningful use—namely, CCDA and CEHRT.

Two meaningful use dates now loom large. The first is December 15, when the 60-day comment period on the stage 3 final rule expires. While some industry observers consider the comment period to pertain just to stage 3, that isn't precisely true. Because ONC and CMS issued a single final rule covering both stage 3 and its amendments to stage 2 in the years 2015, 2016, and 2017, the public has the right to comment on anything in the final rule, says Liz Johnson, CIO of acute care hospitals and applied clinical informatics at Tenet Healthcare, the for-profit hospital operator headquartered in Dallas.

Nurses with a passion for data – that’s one of the key components of success for chief nurse informatics officers.

Those in this role in healthcare organizations understand the specific pressures and duties that nurses face, and how information technology can help improve their ability to deliver care to patients, and use the right IT tools to accomplish that goal.

Several board members of the American Nursing Informatics Association recently shared from their past experiences, aiming to help nursing students and new chief nurse informatics officers with the lessons they learned in their early years as CNIOs.

Federal agencies in 2010 started work to create the Direct Project secure messaging protocols as a simple and standard way to exchange encrypted health information. Only now, however, are agencies starting to adopt the technology.

Over time, Direct messaging has evolved to be a supporting messaging option under the electronic health records Meaningful Use program, and is governed by DirectTrust, a coalition of 150 provider and vendor organizations.

Now, the Department of Veterans Affairs and Indian Health Services have received accreditation from the industry-sponsored Electronic Healthcare Network Accreditation Commission for meeting specific requirements for security and identity controls as health information service providers using Direct messaging services.

Terminology is core to everything in healthcare—from procedures to results to diagnoses. As healthcare organizations increasingly rely on information systems, agreeing on terminology usage and standards is critical to improving care, conducting analytics and other important initiatives.

Unfortunately, no single healthcare vocabulary or terminology can meet all the needs of those who use healthcare information. The variety in terminologies and the variability in how they are used has created an environment of data being trapped in silos. To improve healthcare delivery and research, terminology barriers need to be addressed.

This was the topic addressed in a recent roundtable discussion hosted by Health Data Management and sponsored by Health Language. Here is the first in a weeklong series addressing terminology challenges and possible solutions.

Over the next five years, U.S. health systems stand to lose a total of $305 billion from coordinated cyberattacks, according to Accenture. Even worse, their patients are at big financial risk themselves.

"What most health systems don't realize is that many patients will suffer personal financial loss as a result of cyberattacks on medical information," said Kaveh Safavi, MD, managing director of Accenture's global healthcare business, in a statement. "If healthcare providers are complacent to safeguarding personal information, they'll risk losing substantial revenues and patients as a result of medical identity theft."

Healthcare organizations are starting to prioritize business intelligence (BI) and analytics initiatives, but challenges remain, according to a survey from HIMSS Analytics and Qlik, a Randor, Pa.-based visual analytics company.

The study, which surveyed 400 respondents, including C-suite, vice president, and director level contacts, confirms implementation of and utilization of BI and analytics platforms result in better decision-making across all segments of a healthcare organization.

With four key areas explored—level of maturity across a variety of use cases, value that has been realized from current initiatives, challenges experienced from current deployments, and future investment plans in healthcare analytics—the survey revealed that BI and analytics platforms provide better internal transparency for easy recognition of clinical and operational efficiencies which can lead to reduction in the average length of stay and higher patient satisfaction.